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Baby blues (or pink?)

By Ranjani Rao

An online pregnancy store caters exclusively to a pregnant clientele and besides vitamins and baby books, it also sells a newly developed diagnostic kit that uses only a few drops of maternal blood to conclusively tell you the sex of an unborn child. As early as six weeks into gestation, with just a finger-prick for a few drops of the mother-to-be’s blood, with greater than 99.9 accuracy and without a need for a prescription, it tells you within 48 hours, whether your offspring will be a boy or girl. A sophisticated laboratory technique is used to detect the sex of the unborn child from the fetal DNA that circulates in maternal blood. As a scientist I celebrate this practical application of cutting-edge technology, but as a woman from a region of the world that favors males, I dread its implications and applications.

In modern India, preference for a male child continues to run rampant, cutting across lines of region, religion, caste and class, just as it did in every preceding generation. According to the 2001 census, the child sex ratio (number of girls per 1,000 boys in the 0-6 age group) stands at 845, a significant drop from 904 in 1991. When this drop is plotted along state lines on the Indian map, it is clear that this curse is spread uniformly across the landscape. The decline in the number of girls, while remarkable in itself is more shocking because the worst drops have been noticed not among the rural poor but the urban elite. Cities like Delhi and Mumbai show a sharp drop and within each city, the sharpest declines are in the most affluent pockets. The widespread belief that a son is required to perpetuate the family lineage is one that influences even the educated urban population that equates having a son to enhanced social prestige.

While education, exposure and affluence have not inculcated a culture of equality of the sexes, it has enabled access to sophisticated diagnostic tools to favor the process of sex selection. Although not as accurate as the more invasive amniocentesis, the widespread use of ultrasound technology to determine the sex of fetus, which inevitably led to subsequent abortion of the female fetus, resulted in the Prenatal Diagnostic Technique Act and Rules-1994 which banned the use of medical intervention for the purpose of sex determination. The Act prohibits sex selection before and after conception and also regulates the use of diagnostic techniques that are used for detecting genetic abnormalities and other disorders. Medical practitioners and institutions using such technologies are liable for penalties if found guilty of violating the law. Even persons seeking such intervention can be fined or imprisoned.

For the wealthy Indian, this ban was never a true deterrent since the diagnosis could be easily done outside the country and an abortion could be readily completed inside. Unlike in the U.S, abortion is legal here, a provision in the law ostensibly to give more reproductive freedom to women in a country already suffering from the burden of a large and growing population. For the illiterate and economically downtrodden, bearing daughters is a double burden. Along with the social stigma, with the dark cloud of dowry looming over the future, the mothers sometimes resort to the barbaric practice of female infanticide.

What then, is the use of such a technology in this social climate? A young mother of two adorable little girls who lives in my neighborhood is recovering from the trauma of having given birth to a still-born baby boy just a few weeks ago. I wonder if this scientific advance would benefit her in the quest to please her mother-in-law by producing a male heir for the family. An early detection may only lead to early termination and more frequent cycles of conception, detection and abortion until the baby turns out to be of the desired sex. And then again, that in itself is no guarantee that the pregnancy will continue to term with a live birth.

While the progress of science must not be hindered, the accompanying ethical dilemma and potential for misuse should not be ignored. In China, rapid decline in fertility, continuing preference for male children and use of medical diagnostic technology to abort female fetuses, has led to a situation where over 23 million young men will be unable to find female partners in the coming decades. Such skewed sex ratios will undoubtedly have unthinkable social consequences. Perhaps just an increasing awareness of how developing technologies can have unexpected beneficial or detrimental impact across today’s shrinking and connected world is not enough. What we need is a global effort to ensure an equal commitment to ethical practices, a basic sense of justice, and the goal of uniform improvement of mankind on the part of both the developers and the users of such technology.

In India, it may be a while before the birth of a girl is heralded with uninhibited joy. In the meantime, we need not just educated but enlightened parents who truly rejoice in their daughters, who offer equal opportunities to their sons and daughters and who, like me, consider their family complete even without a son. Ultimately, every daughter who will grow up in such a family, will not thirst for a son or expose herself to unreasonable risk to satisfy those who seek sons for their salvation. Then advances in prenatal sex detection/selection techniques will be of no consequence because pink or blue, anyone will do.

mmo : november 2005

Ranjani Rao is a scientist by training, a writer by choice and like all mothers, is first a full-time mother. Educated both in India and US, she lived and worked in the US for several years before returning to India. Ranjani currently lives, works and writes from Hyderabad, India.
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